Name:
First Name
Last Name
Birth Date
Please select a month
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Please select a day
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Day
Please select a year
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Year
E-mail Address:
Phone Number:
Format: (000) 000-0000.
Address
DIVISION APPLYING FOR
SERVICE
CONTRACT
CORPORATE
WHAT JOB ARE YOU APPLYING FOR
POSITION APPLYING FOR
ACCOUNTING
CORPORATE
CSR
DOOR TECHNICIAN
ESTIMATING
GLASS INSTALL APPRENTICE (HELPER)
GLASS INSTALLER (GLAZIER)
MANAGEMENT
MARKETING
PROJECT MANAGER
PROJECT MANAGER - ASSITANT
SALES
OTHER
WHAT JOB ARE YOU APPLYING FOR
WHAT DATE ARE YOU AVAILABLE TO START
How were you referred to us?
Ad
Craigslist
Walk-In
Facebook
Employee
Other (please specify)
CURRENT EMPLOYER NAME
DAYS AVAILABLE TO WORK (select all the apply)
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
AVAILABILITY
FULL TIME
PART TIME
SHIFT WORK
TEMPORARY
SALARY TYPE
SALARY
HOURLY
YEARLY SALARY $
HOURLY RATE$
RELIABLE MEASNS OF TRANSPORTATION?
YES
NO
HAVE YOU WORKED FOR S. ALBERT GLASS PRIOR?
YES
NO
IF YES, please give dates & position
Do you have friends and/or relatives currently working @ S. Albert Glass?
YES
NO
IF YES, please give names & position
Are you at least 18 Years Old?
YES
NO
Can you present evidence of your identity or legal right to work in this country?
YES
NO
Have you ever used a another name?
YES
NO
Is any additional info relative to name changes, use of assumed name, or nickname necessary to enable a check on your work and educational record?
YES
NO
IF YES, please give your other names and provide an explanation
EMPLOYMENT EXPERIENCE
*Please list the names of your present or previous employers in chronological order
*If Self-Employed, please provide company name and supply business references
EMPLOYER #1
Employer Address
Employer Phone Number
Format: (000) 000-0000.
START DATE
END DATE
May we contact your Supervisor
YES
NO
Supervisor Name
Supervisor Phone Number
Format: (000) 000-0000.
Supervisor Email
example@example.com
JOB TITLE & DUTIES
BE BRIEF YET DECRIPTIVE
REASON FOR LEAVING
BE BRIEF YET DECRIPTIVE
EMPLOYER #2
Employer Address
Employer Phone Number
Format: (000) 000-0000.
START DATE
END DATE
May we contact your Supervisor
YES
NO
Supervisor Name
Supervisor Phone Number
Format: (000) 000-0000.
Supervisor Email
example@example.com
JOB TITLE & DUTIES
BE BRIEF YET DECRIPTIVE
REASON FOR LEAVING
BE BRIEF YET DECRIPTIVE
EMPLOYER #3
Employer Address
Employer Phone Number
Format: (000) 000-0000.
START DATE
END DATE
May we contact your Supervisor
YES
NO
Supervisor Name
Supervisor Phone Number
Format: (000) 000-0000.
Supervisor Email
example@example.com
JOB TITLE & DUTIES
BE BRIEF YET DECRIPTIVE
REASON FOR LEAVING
BE BRIEF YET DECRIPTIVE
Have you ever been involuntarily or asked to resign from any job?
YES
NO
If Yes, Please Explain
BE BRIEF YET DESCRIPTIVE
Please Explain any gaps in your employment
BE BRIEF YET DESCRIPTIVE
Job Skills & Training
SKILLS:
THAT WILL HELP ON JOB
Training or Certifications:
EDUCATION
Rows
SCHOOL NAME
YEARS COMPLETED
DIPLOMA/DEGREE
Area of Study/Major
Specialized Training/Skills/Extra-Curricular
HIGH SCHOOL
COLLEGE
GRADUATE/PROFESSIONAL SCHOOL
TRADE SCHOOL
OTHER
PROFESSIONAL REFERENCES
Please list THREE (3) references
*PROFESSIONAL* REFERENCE #1 NAME
TITLE
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Years Known:
*PROFESSIONAL* REFERENCE #2 NAME
TITLE
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Years Known:
*PROFESSIONAL* REFERENCE #3 NAME
TITLE
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Years Known:
PERSONAL REFERENCES
Please list THREE (3) references
*PERSONAL* REFERENCE #1 NAME
Relationship
Email
example@example.com
Phone Number
Format: (000) 000-0000.
*PERSONAL* REFERENCE #2 NAME
Years Known:
RELATIONSHIP
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Years Known:
*PERSONAL* REFERENCE #3 NAME
RELATIONSHIP
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Years Known:
DRIVERS LICENCE
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UPLOAD PICTURE(S) OF YOUR VALID DRIVERS LICENCE (FRONT+BACK)
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of
UPLOAD RESUME
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SEND IN YOUR RESUME OR OTHER FILES
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of
A ) I hereby authorize the Company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to the Company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
I AGREE
B) In the event of my employment with the Company, I understand that I am required to comply with all rules and regulations of the Company. If hired, I understand and agree that my employment with the Company is at-will, and that neither I, nor the Company is required to continue the employment relationship for any specific term. I further understand that the Company or I may terminate the employment relationship at any time, with or without cause, and with or without notice.
I AGREE
C) I understand that the at will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.
I AGREE
D) I understand that safety of employees is extremely important to the Company and that the Company is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor.
I AGREE
E) I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.
I AGREE
F) I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
I AGREE
G) I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration laws require me to complete an I-9 Form in this regard. I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed and the remainder of this Agreement shall be enforceable.
I AGREE
Signature
I CERTIFY THAT ALL INFO PROVIDED IS TRUTHFUL
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